RESUMEN
Diagnostic indices of Gal/Gal NAc lectin antigen and anti-lectin antibodies for amebic liver abscess were evaluated to see their usefulness. Forty [40] clinically suspected cases of liver abscess patients admitted in the Rajshahi Medical College Hospital [RMCH], Bangladesh during January to December 2007 were included. Liver abscess pus from all cases were tested for small subunit of ribosomal RNA [rRNA] gene of Entamoeba histolytica by Real Time PCR and only PCR-positive cases were further analyzed for detection of Gal/Gal NAc lectin antigen and anti-lectin antibodies in their liver abscess aspirates, plasma, saliva and urine using Enzyme-linked immunosorbent assay [ELISA] methods. Except liver abscess pus, all other samples were also tested for 20 patients suffering from diseases other than liver abscess, who served as controls for the study. Out of 40 patients, 39 were PCR-positive and considered as confirmed cases of amebic liver abscess. The rate of detection of lectin antigen and anti-lectin antibody in liver abscess pus was 12.82% and 56.41% respectively. Diagnostic sensitivities of lectin antigen in plasma, saliva and urine were 15.38% [95%CI 6-31%], 07.69% [95%CI 2-22%] and 00% respectively, while sensitivities of anti-lectin antibodies in all those samples were 100% [95%CI 88-100%], 87.17% [95%CI 72-95%] and 56.41% [95%CI 40-78%] respectively. Diagnostic specificities of lectin antigen was 100% in all specimens but for anti-lectin antibodies, specificities were 100% [95%CI 88- 100%] in plasma, 50% [95%CI 28-78%] in saliva and 70% [95%CI 46-87%] in urine. Overwhelming majority of cases [94.87%] received Metronidazole therapy for variable period before sample collection, which is correlated with low rate of antigen detection. Detection of lectin antigen for amebic liver abscess has very limited or no role where Metronidazole is used indiscriminately but detection of anti-lectin antibodies especially in plasma [100% sensitivity] and saliva [87.17% sensitivity] are excellent to satisfactory. Estimation of plasma IgG can be recommended as serodiagnostic tool for symptomatic amebic liver abscess
RESUMEN
The study was carried out to assess the reliability of Immunochromatographic test for gonococcal antigen in urethral swabs from suspected male patients to validate it as rapid and point-of-care test for gonorrhoea. A total of 80 clinically suspected cases of gonorrhoea in males of different age groups attending at the Skin and VD out patient department of Rajshahi Medical College Hospital [RMCH], Bangladesh during January to December, 2007 were enrolled. Urethral and/or prostatic secretions were collected aseptically for bacterial culture in Chocolate agar media, Gram-stained smear microscopy for gram-negative diplococci and rapid test by Immunochromatographic assay. Out of 80 samples, culture yielded growth of Neisseria gonorrhoeae in 47 [58.75%] cases, and microscopy revealed gram-negative diplococci in 45 [56.25%] cases. Immunochromatographic test was performed by following manufacturer's instructions in randomly selected 50 cases including 38 urethral swabs and 12 prostatic secretions with 35 cases found positive against 36 of those culture-positive cases. Considering culture as gold standard of diagnosis, sensitivity, specificity, positive and negative predictive values of Immunochromatographic test were calculated as 97.22% [95% CI 83-99%], 100% [95% CI 73-100%], 100%, and 93.33% respectively. This limited study reinforces that detection of gonococcal antigen by Immunochromatographic assay is a rapid, easy to perform and reliable diagnostic tool for early detection of acute male gonorrhoea with high sensitivity and specificity. It may be a useful test for screening clinically suspected case of gonococcal infections in male, particularly suitable as point-of-care test